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	xmlns:wicket="http://wicket.sourceforge.net/" xml:lang="en" lang="en">
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<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<wicket:head>
	<title>UYIFL - Take it Indoors - Registration</title>
</wicket:head>
</head>
<body>
<wicket:extend>


	<h3>Register here for Spring Football 2011</h3>
	<!--  ************FORM*******************-->
	<form wicket:id="registrationForm">
	<table width="600" border="2">
		<tr>
			<td colspan="4">
			<h4>Players Information</h4>
			</td>
		</tr>
		<tr>
			<td colspan="1">First Name:</td>

			<td colspan="3"><input name="pfname" wicket:id="pfname"
				id="fName" type="text" size="20" maxlength="40" /></td>
		</tr>
		<tr>
			<td colspan="1">Last Name:</td>

			<td colspan="3"><input name="plname" wicket:id="plname"
				id="LName" type="text" size="20" maxlength="40" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Address 1: </label></td>
			<td colspan="3"><input name="padd1" wicket:id="padd1"
				id="Address1" type="text" size="20" maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Address 2: </label></td>
			<td colspan="3"><input name="padd2" wicket:id="padd2"
				id="Address2" type="text" size="25" maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> City: </label></td>
			<td colspan="3"><input name="pcity" wicket:id="pcity"
				type="text" size="20" maxlength="30" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> State: </label></td>
			<td><select name="pState" size="1" id="state">

				<option value="">Please Select</option>
				<option value="UT">Utah</option>
				<option value="AL">Alabama</option>
				<option value="AK">Alaska</option>
				<option value="AZ">Arizona</option>
				<option value="AK">Arkansas</option>
				<option value="CA">California</option>
				<option value="CO">Colorado</option>
				<option value="CT">Connecticut</option>
				<option value="DE">Delaware</option>
				<option value="FL">Florida</option>
				<option value="GA">Georgia</option>
				<option value="HI">Hawaii</option>
				<option value="ID">Idaho</option>
				<option value="IL">Illinois</option>
				<option value="IN">Indiana</option>
				<option value="IA">Iowa</option>
				<option value="KS ">Kansas</option>
				<option value="KY">Kentucky</option>
				<option value="LA">Louisiana</option>
				<option value="ME">Maine</option>
				<option value="MD">Maryland</option>
				<option value="MA">Massachusetts</option>
				<option value="MI">Michigan</option>
				<option value="MN">Minnesota</option>
				<option value="MS">Mississippi</option>
				<option value="MO">Missouri</option>
				<option value="MT">Montana</option>
				<option value="NE">Nebraska</option>
				<option value="NV">Nevada</option>
				<option value="NH">New Hampshire</option>
				<option value="NJ">New Jersey</option>
				<option value="NM">New Mexico</option>
				<option value="NY">New York</option>
				<option value="NC">North Carolina</option>
				<option value="ND">North Dakota</option>
				<option value="OH">Ohio</option>
				<option value="OK">Oklahoma</option>
				<option value="OR">Oregon</option>
				<option value="PA">Pennsylvania</option>
				<option value="RI">Rhode Island</option>
				<option value="SC">South Carolina</option>
				<option value="SD ">South Dakota</option>
				<option value="TN">Tennessee</option>
				<option value="TX">Texas</option>
				<option value="VT">Vermont</option>
				<option value="VA">Virginia</option>
				<option value="WA">Washington</option>
				<option value="WV">West Virginia</option>
				<option value="WI">Wisconsin</option>
				<option value="WY">Wyoming</option>
			</select> <!-- <input name="pstate" type="text" size="20" maxlength="30" /> -->
			</td>
		</tr>
		<tr>
			<td><label> Zip Code: </label></td>
			<td><input name="pzip" wicket:id="pzip" type="text" size="8"
				maxlength="10" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Home Phone: </label></td>
			<td colspan="3"><input name="phphone" wicket:id="phphone"
				type="text" size="20" maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Cell Phone: </label></td>
			<td colspan="3"><input name="pcphone" wicket:id="pcphone"
				type="text" size="20" maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Email Address: </label></td>
			<td colspan="3"><input name="pemail" wicket:id="pemail"
				type="text" size="20" maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Birthday: </label></td>
			<td colspan="3"><input name="pbirth" wicket:id="pbirth"
				type="text" size="20" maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Sex: </label></td>
			<td><input type="radio" name="sex" value="male" />Male</td>
			<td colspan="3"><input type="radio" name="sex" value="female" />Female</td>
		</tr>
		<tr>
			<td colspan="1"><label> Shirt Size: </label></td>
			<td colspan="3"><input name="ssize" type="text"
				wicket:id="ssize" size="20" maxlength="25" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Pant Size:</label></td>
			<td colspan="3"><input name="psize" type="text"
				wicket:id="psize" size="20" maxlength="25" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Weight: </label></td>
			<td colspan="3"><input name="pweight" type="text"
				wicket:id="pweight" size="20" maxlength="50" /></td>
		</tr>
		
		<tr>
			<td colspan="1"><label> Lives With: </label></td>
			<td colspan="3"><input name="livew" wicket:id="livew"
				type="text" size="20" maxlength="30" /></td>
		</tr>
		
		<tr>
			<td colspan="4">
			<h4>Emergency Contact Information</h4>
			</td>
		</tr>
		<tr>
			<td colspan="1"><label> Name: </label></td>
			<td colspan="3"><input name="ecname" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Phone 1: </label></td>
			<td colspan="3"><input name="ecphone1" type="text" size="20"
				maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Phone 2: </label></td>
			<td colspan="3"><input name="ecphone2" type="text" size="20"
				maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Relationship: </label></td>
			<td colspan="3"><input name="ecrelation" type="text" size="20"
				maxlength="30" /></td>
		</tr>
		
		
		<tr>
			<td colspan="4">
			<h4>Parent #1</h4>
			</td>
		</tr>
		<tr>
			<td colspan="1"><label> First Name: </label></td>
			<td colspan="1"><input name="gfname1" type="text" size="20"
				maxlength="40" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Last Name: </label></td>
			<td colspan="1"><input name="glname1" type="text" size="20"
				maxlength="30" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Address: </label></td>
			<td colspan="3"><input name="gadd11" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Address 2: </label></td>
			<td colspan="3"><input name="gadd21" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> City: </label></td>
			<td colspan="1"><input name="gcity1" type="text" size="15"
				maxlength="30" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> State: </label></td>
			<td colspan="1"><select name="gState1" size="1" id="state">
				<option value="">Please Select</option>
				<option value="UT">Utah</option>
				<option value="AL">Alabama</option>
				<option value="AK">Alaska</option>
				<option value="AZ">Arizona</option>
				<option value="AK">Arkansas</option>
				<option value="CA">California</option>
				<option value="CO">Colorado</option>
				<option value="CT">Connecticut</option>
				<option value="DE">Delaware</option>
				<option value="FL">Florida</option>
				<option value="GA">Georgia</option>
				<option value="HI">Hawaii</option>
				<option value="ID">Idaho</option>
				<option value="IL">Illinois</option>
				<option value="IN">Indiana</option>
				<option value="IA">Iowa</option>
				<option value="KS ">Kansas</option>
				<option value="KY">Kentucky</option>
				<option value="LA">Louisiana</option>
				<option value="ME">Maine</option>
				<option value="MD">Maryland</option>
				<option value="MA">Massachusetts</option>
				<option value="MI">Michigan</option>
				<option value="MN">Minnesota</option>
				<option value="MS">Mississippi</option>
				<option value="MO">Missouri</option>
				<option value="MT">Montana</option>
				<option value="NE">Nebraska</option>
				<option value="NV">Nevada</option>
				<option value="NH">New Hampshire</option>
				<option value="NJ">New Jersey</option>
				<option value="NM">New Mexico</option>
				<option value="NY">New York</option>
				<option value="NC">North Carolina</option>
				<option value="ND">North Dakota</option>
				<option value="OH">Ohio</option>
				<option value="OK">Oklahoma</option>
				<option value="OR">Oregon</option>
				<option value="PA">Pennsylvania</option>
				<option value="RI">Rhode Island</option>
				<option value="SC">South Carolina</option>
				<option value="SD ">South Dakota</option>
				<option value="TN">Tennessee</option>
				<option value="TX">Texas</option>
				<option value="UT">Utah</option>
				<option value="VT">Vermont</option>
				<option value="VA">Virginia</option>
				<option value="WA">Washington</option>
				<option value="WV">West Virginia</option>
				<option value="WI">Wisconsin</option>
				<option value="WY">Wyoming</option>
			</select> <!-- <input name="gstate" type="text" size="10" maxlength="30" />  -->
			</td>
		</tr>
		<tr>
			<td colspan="1"><label> Zip Code: </label></td>
			<td colspan="1"><input name="gzip1" type="text" size="8"
				maxlength="10" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Home Phone: </label></td>
			<td colspan="1"><input name="ghphone1" type="text" size="10"
				maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Cell Phone: </label></td>
			<td colspan="1"><input name="gcphone1" type="text" size="10"
				maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Email Address: </label></td>
			<td colspan="1"><input name="gemail1" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Relationship: </label></td>
			<td colspan="1"><input name="relate1" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Occupation:</label></td>
			<td colspan="1"><input name="occupation1" type="text" size="20"
				maxlength="50" /></td>

		</tr>

		<tr>
			<td colspan="4">
			<h4>Parent #2</h4>
			</td>
		</tr>
		<tr>
			<td colspan="1"><label> First Name: </label></td>
			<td colspan="3"><input name="gfname2" type="text" size="20"
				maxlength="40" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Last Name: </label></td>
			<td colspan="3"><input name="glname2" type="text" size="20"
				maxlength="30" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Address: </label></td>
			<td colspan="3"><input name="gadd12" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Address 2: </label></td>
			<td colspan="3"><input name="gadd22" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> City: </label></td>
			<td colspan="1"><input name="gcity2" type="text" size="15"
				maxlength="30" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> State: </label></td>
			<td colspan="1"><select name="gState2" size="1" id="state">
				<option value="">Please Select</option>
				<option value="UT">Utah</option>
				<option value="AL">Alabama</option>
				<option value="AK">Alaska</option>
				<option value="AZ">Arizona</option>
				<option value="AK">Arkansas</option>
				<option value="CA">California</option>
				<option value="CO">Colorado</option>
				<option value="CT">Connecticut</option>
				<option value="DE">Delaware</option>
				<option value="FL">Florida</option>
				<option value="GA">Georgia</option>
				<option value="HI">Hawaii</option>
				<option value="ID">Idaho</option>
				<option value="IL">Illinois</option>
				<option value="IN">Indiana</option>
				<option value="IA">Iowa</option>
				<option value="KS ">Kansas</option>
				<option value="KY">Kentucky</option>
				<option value="LA">Louisiana</option>
				<option value="ME">Maine</option>
				<option value="MD">Maryland</option>
				<option value="MA">Massachusetts</option>
				<option value="MI">Michigan</option>
				<option value="MN">Minnesota</option>
				<option value="MS">Mississippi</option>
				<option value="MO">Missouri</option>
				<option value="MT">Montana</option>
				<option value="NE">Nebraska</option>
				<option value="NV">Nevada</option>
				<option value="NH">New Hampshire</option>
				<option value="NJ">New Jersey</option>
				<option value="NM">New Mexico</option>
				<option value="NY">New York</option>
				<option value="NC">North Carolina</option>
				<option value="ND">North Dakota</option>
				<option value="OH">Ohio</option>
				<option value="OK">Oklahoma</option>
				<option value="OR">Oregon</option>
				<option value="PA">Pennsylvania</option>
				<option value="RI">Rhode Island</option>
				<option value="SC">South Carolina</option>
				<option value="SD ">South Dakota</option>
				<option value="TN">Tennessee</option>
				<option value="TX">Texas</option>
				<option value="UT">Utah</option>
				<option value="VT">Vermont</option>
				<option value="VA">Virginia</option>
				<option value="WA">Washington</option>
				<option value="WV">West Virginia</option>
				<option value="WI">Wisconsin</option>
				<option value="WY">Wyoming</option>
			</select> <!-- <input name="gstate" type="text" size="10" maxlength="30" />  -->
			</td>
		</tr>
		<tr>
			<td colspan="1"><label> Zip Code: </label></td>
			<td colspan="1"><input name="gzip2" type="text" size="8"
				maxlength="10" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Home Phone: </label></td>
			<td colspan="1"><input name="ghphone2" type="text" size="10"
				maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Cell Phone: </label></td>
			<td colspan="1"><input name="gcphone2" type="text" size="10"
				maxlength="12" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Email Address: </label></td>
			<td colspan="1"><input name="gemail2" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Relationship: </label></td>
			<td colspan="1"><input name="relate2" type="text" size="20"
				maxlength="50" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Occupation:</label></td>
			<td colspan="1"><input name="occupation2" type="text" size="20"
				maxlength="50" /></td>

		</tr>
		<tr>
			<td colspan="4">
			<h4>Coach or Team Information</h4>
			</td>
		</tr>
		<tr>
			<td colspan="1"><label> Coach: </label></td>
			<td colspan="3"><input name="cname" type="text"
				wicket:id="cname" size="20" maxlength="40" /></td>
		</tr>
		<tr>
			<td colspan="1"><label> Team Name: </label></td>
			<td colspan="3"><input name="tmname" type="text"
				wicket:id="tmname" size="20" maxlength="40" /></td>
		</tr>
		<tr>
			<td colspan="4">
			<h4>Additional Comments</h4>
			</td>
		</tr>
		<tr>
			<td colspan="4"><textarea name="Comments" rows="10" cols="60">
                              
                            </textarea></td>
		</tr>
		<tr>
			<td colspan="2"><input type="submit" value="Continue" /></td>
		</tr>
	</table>
	</form>
	<p id="Error"></p>
	<br />
</wicket:extend>
</body>
</html>